It's open enrollment season again. Oh joy

I've been writing about healthcare policy for over a decade, and I still dread open enrollment. With so many variables, it's hard to find the right path. ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ [Los Angeles Times] [Essential California Newsletter] November 1, 2022 [View in browser]( [Click to view images]( promoting Covered California hang at the Bloc in downtown Los Angeles at the start of open enrollment in 2019. (Mel Melcon / Los Angeles Times) By Jon Healey Good morning, and welcome to the Essential California [newsletter](. It’s Tuesday, Nov. 1 — T-minus seven days until the midterms. I’m Jon Healey, senior editor of the Utility Journalism Team, offering explanations and answers from my perch in South Pasadena. There’s not just an election looming, but it’s also a time when millions of Americans have to decide what kind of health insurance to carry for the coming year. Heaven forfend that we should ever need the coverage, but it’s a risky bet to go without insurance if you can afford it. Open enrollment for Medicare began on [Oct. 15 and runs through Dec. 7](. Many employer health plans, which typically have shorter open enrollments and variable dates, have also started briefing workers on their options and calling on them to make decisions. And for anyone not covered by an employer’s comprehensive health plan, today is when [open enrollment begins at Covered California]( the health insurance marketplace created by the 2010 Affordable Care Act. Covered California’s subsidized policies are available to some households that have access to an employer’s health plan too, which I’ll explain in a bit. I’ve been writing about healthcare policy for more than a decade, and I still dread open enrollment. There are just so many variables — premiums! deductibles! copays! networks! tax strategies! — that I struggle to figure out the right path. And I like math. In part, that’s because the system makes you bet how much care you and your family will need in the coming year. If you don’t think you’ll need much care, you can go for a high-deductible plan and save on premiums. But if you bet wrong, the pain will be both physical and financial. (One other pain point: Premiums are [rising about 6%]( on average in the coming year, a sharper increase than we’ve seen in the last few years. Oddly enough, the pandemic held insurance costs down by reducing the demand for healthcare, but things are now getting back to normal.) Covered California [has its issues]( but it has worked to simplify the choices faced by its customers, who don’t have the benefit of a company human resources team to guide them. It has standardized the insurance plans offered in the various tiers to help you make apples-to-apples comparisons. For example, the difference between one “silver” plan and another boils down mainly to provider networks and premiums, not how much you’ll pay for which services. Covered California also provides easy-to-grasp quality ratings, and is imposing standards on insurers to push them to [improve patient outcomes in key areas](. Yet there is one not-so-simple aspect to getting insurance from Covered California: figuring out whether you and your family qualify for subsidies. If your employer offers you health insurance, you won’t be eligible for discounted premiums from Covered California unless your health plan at work would cost more than 9.12% of your household’s annual income. But your spouse and kids might be eligible for Covered California’s subsidies if the cost of your employer’s family coverage crosses the 9.12% threshold. In that case, the lowest-cost approach may well be for you to carry two policies — one for you from your employer, and one for the rest of your family from Covered California. But that might mean two different networks of doctors, dentists and other healthcare professionals. I explained the situation in greater detail in [this piece](. But don’t let the complication stop you from signing up for coverage! In California, you have to — the penalty for going uninsured is at least $850 per adult and $425 per dependent child younger than 18. And now, here’s what’s happening across California: Note: Some of the sites we link to may limit the number of stories you can access without subscribing. ADVERTISEMENT L.A. 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Times newsroom, delivers the most interesting stories from the Los Angeles Times every Monday, Wednesday and Friday. [Listen and subscribe]( wherever you get your podcasts. POLITICS AND GOVERNMENT [A woman in a sleeveless black dress speaks into a microphone. In the background is an American flag.] Rep. Katie Porter speaks during a campaign stop at the Huntington Landmark senior community in Huntington Beach on Oct. 17. (Myung J. Chun / Los Angeles Times) Will Orange County prove too red for Katie Porter? A national Democratic star, Porter is locked in a fierce race against Republican Scott Baugh. It’s a battle not just over her political trajectory and the balance of power in the House but also for Orange County’s ideological identity. [Los Angeles Times]( Gov. Gavin Newsom campaigned on building 3.5 million homes. He hasn’t gotten even close. “Just 13% of the 3.5 million homes he campaigned on building have been permitted, let alone built.” [CalMatters]( As Proposition 29 vote looms, dialysis patients brace for change. For the third time, Californians will have a chance next month to vote on whether to impose major new rules on dialysis clinics statewide that could affect as many as 80,000 patients. [Los Angeles Times]( Last-minute oil millions flowing to moderate California Democrats are a “double-edged sword.” Oil companies are spending heavily on campaign ads in an effort to unseat two Democrats also regarded as moderates (by California Legislature standards). [Sacramento Bee]( Would Proposition 1 allow abortions after fetal viability? Legal experts say no. It’s not only the language of the proposed constitutional amendment that counts, they say, but also the context. [CalMatters]( Excuse me, did you forget something? The State Controller’s Office is [holding $12 billion]( in unclaimed property, including funds from abandoned bank accounts and unclaimed life insurance payouts. [Sacramento Bee]( CRIME, COURTS AND POLICING [Police tape is seen in the foreground. In back, police units are parked alongside a stately mansion on a city street.] Police work outside House Speaker Nancy Pelosi’s Pacific Heights home after the assault on her husband, Paul Pelosi. (Anadolu Agency via Getty Images) Attack suspect David DePape intended to kidnap, “kneecap” Nancy Pelosi, prosecutors allege. This story gets more bizarre by the day. [Los Angeles Times]( Ex-girlfriend of suspect in Paul Pelosi attack says he struggled with mental illness, drugs, believed he was “Jesus for a year.” What I meant was, this story gets more bizarre by the hour. [San Francisco Chronicle]( Another study finds racial disparities in stop data at sheriff’s departments across the state. Examining data from Sacramento, Los Angeles, Riverside and San Diego counties, Catalyst California and the American Civil Liberties Union of Southern California found that deputies at all departments stopped Black people at higher rates than white people. That was particularly true for traffic stops. [San Diego Union-Tribune]( $3.4-million ID theft scam targeted poor Southern California homeowners, DA says. Three residents of Los Angeles, Ventura and Riverside counties are accused of fraudulently taking out home improvement loans in the names of 32 different victims. [Orange County Register]( (subscribers only) Danny Masterson’s accusers feared being kicked out of Scientology — as his stepfather was. “When it happened, I cried. It’s my kids. I raised my children and now they’ve turned against their dad,” Joe Reaiche said in an interview with The Times. “Not because of my decision, but because of the church’s decision. That’s the evil of disconnection.” [Los Angeles Times]( A West Los Angeles man has been sentenced to 18 years for harassing female VA doctors. “This defendant earned a lengthy prison sentence by terrorizing his victims for years,” U.S. Atty. Martin Estrada said of 51-year-old Gueorgui Hristov Pantchev. [MedPage Today]( Support our journalism [Subscribe to the Los Angeles Times.]( ADVERTISEMENT HEALTH AND THE ENVIRONMENT [An aerial view of a concrete river channel bordered by blocks of homes.] An aerial view of the Los Angeles River west of DeForest Park in north Long Beach. (Allen J. Schaben / Los Angeles Times) Major flood would hit Los Angeles Black communities disproportionately hard, study finds. UC Irvine researchers also find that a 100-year flood in the Los Angeles Basin would put roughly 30 times as many people at risk as the Federal Emergency Management Agency has estimated. [Los Angeles Times]( Accidental carbon dioxide release at LAX leaves four workers sick, one critically. The leak occurred in an underground electrical room near Terminal 8’s baggage claim area. Much also could be said about deliberate carbon dioxide releases on the LAX tarmac. [Los Angeles Times]( Atmospheric rivers will hit the West soon. What does it mean for California? It all depends on the route the weather system takes. If you want rain in L.A., hope for the route to dip to the south. [San Francisco Chronicle]( CALIFORNIA CULTURE How UC Irvine became an esports hotbed. This isn’t quite NCAA football or basketball, but Irvine has a dedicated esports arena, a coaching staff and uniformed squads playing in leagues based on three popular games: “Overwatch 2,” “League of Legends” and “Valorant.” One can only imagine the Red Bull budget. [Los Angeles Times]( [The exterior of a spooky house with mist and lantern light.] The Haunted Mansion was especially festive at an after-hours Disneyland event. (Todd Martens / Los Angeles Times) How Disneyland’s Haunted Mansion popularized the haunted house and changed Halloween forever. “It turns out we have Walt Disney to thank for revolutionizing modern Halloween entertainment. And it all started with Disneyland’s Haunted Mansion.” [SFGATE]( For some celebs, pay-to-play Twitter verification is the last straw. Of all the horrors new owner Elon Musk might visit on the platform, could there be anything worse than having to pay $20 a month for a blue check? (Hmm, yes?) [Los Angeles Times]( Free online games Get our free daily crossword puzzle, sudoku, word search and arcade games in our new game center at [latimes.com/games](. CALIFORNIA ALMANAC Los Angeles: 69, mostly cloudy. San Diego: 68, partly sunny. San Francisco: 57, showers. San Jose: 59, showers. Fresno: 69, rainy. Sacramento: 61, showers. AND FINALLY Today’s California memory is from Karen Michel: My family moved to Westwood when I was 2½, to a street lined with palm trees. At Christmas time, there would be sales of pine trees painted — flocked, even — in pink and blue. Yes, gendered. I grew up thinking that all Christmas trees looked like this: never green, never un-made-up. Very L.A. And maybe some of those pines were palms. If you have a memory or story about the Golden State, [share it with us](. (Please keep your story to 100 words.) Please let us know what we can do to make this newsletter more useful to you. Send comments to essentialcalifornia@latimes.com. ADVERTISEMENT Thank you for reading the Los Angeles Times Essential California newsletter. Invite your friends, relatives, coworkers to sign up [here](. Not a subscriber? Get unlimited digital access to latimes.com. [Subscribe here](. [Los Angeles Times] Copyright © 2022, Los Angeles Times 2300 E. 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